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Acute Bronchitis in Adults

Medically reviewed by Carmen Pope, BPharm. Last updated on Dec 13, 2023.

What is acute bronchitis?

Acute bronchitis is an infection of the large and medium-sized air tubes (these are called the bronchi) in your lungs. The infection is usually caused by the same viruses that cause a cold or the flu although occasionally it may be caused by bacteria. It usually results in redness, swelling, and increased mucus production within the bronchi. Acute bronchitis may also be called a “chest cold”.

What are the symptoms of acute bronchitis?

A persistent "wet" cough that usually brings up mucus, sputum, or phlegm is the most common symptom of bronchitis. In most, the cough hangs around for less than three weeks, but in a quarter, it may persist for more than 1 month. The sputum may be clear, yellow, or green; however, this does not tell you if the infection is viral or bacterial. Sometimes the sputum may be tinged with blood. Acute bronchitis typically develops within a week of a cold or the flu.

Other symptoms may include:

If you also have a high or persistent fever, seek medical advice. A high fever may indicate a more serious bacterial infection, such as pneumonia, or a viral infection such as influenza. Older people may have a low-grade fever but still have pneumonia. It is important to have a doctor examine you for secondary bacterial pneumonia, which may require an antibiotic. If influenza is diagnosed within 48 hours of symptom onset, an antiviral treatment like oseltamivir (Tamiflu) or zanamivir (Relenza) may be recommended.

Acute bronchitis is temporary and usually does not cause any permanent breathing difficulties. On average, adults with acute bronchitis usually take two to three days off work.

How is acute bronchitis diagnosed?

A doctor will diagnose acute bronchitis based on your collection of symptoms and history of illness. He or she will take a history of your symptoms, listen to your lungs, perform a physical examination, check your vital signs, and may order a chest x-ray or blood work to look for signs of infection.

There are no specific signs or laboratory tests that are diagnostic. The most important condition to rule out is acute pneumonia.

Spirometry (tests that measure your lung function and how well you can inhale/exhale air) may be conducted in some people, particularly those with underlying respiratory conditions such as asthma or COPD.

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How is acute bronchitis treated?

In most people (85%), acute bronchitis will get better by itself within 3 to 10 days, although the cough may linger for weeks. Since most cases are viral, antibiotics will not work and are usually not prescribed. However; some people may develop a secondary bacterial infection on top of their viral infection and medical treatment in a hospital may be necessary especially if they have other medical conditions or if their bronchitis has progressed to pneumonia.

People with underlying conditions, such as allergies, asthma, or chronic obstructive pulmonary disease (COPD), may be prescribed an inhaler (eg, albuterol) and other medications such as corticosteroids (eg, prednisone) to reduce inflammation and open narrowed passages in their lungs.

Other treatments may also be used to relieve your symptoms, although these will not resolve underlying bronchitis any faster. Examples include:

It is also good to rest and drink plenty of fluids. Some people may find a humidifier helps.

Cough suppressants (dextromethorphan, codeine, or benzonatate) have generally not been shown to be helpful.

If you develop new symptoms or your cough worsens or is still present after 3 weeks, contact your physician again. In acute bronchitis, coughing and airway sensitivity can persist for up to 4 to 5 weeks, even after other symptoms have improved; however, you may need further evaluation.

Who is more likely to get acute bronchitis?

Acute bronchitis is common, affecting up to 5% of adults every year. It can occur at any time of the year but is most common in the colder, winter months. Acute bronchitis is most frequently seen in infants, younger children, and seniors. People who smoke; who are exposed to second-hand smoke or excessive air pollution, dust or lung irritants; with other lung diseases such as asthma, lung cancer or COPD, or with certain heart conditions are also at higher risk of acute bronchitis.

Some people with weakened immune systems or other major health problems are more at risk of developing severe problems such as pneumonia or respiratory failure from acute bronchitis. These include:

What causes acute bronchitis?

85% to 95% of cases are caused by viruses, such as rhinovirus, adenovirus, influenza A and B, and parainfluenza virus.

Bacteria can cause bronchitis in people with underlying health problems or complicate a pre-existing viral case. Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Bordetella pertussis are most commonly involved.

Is bronchitis contagious?

Because acute bronchitis is a complication of a viral infection, usually the common cold or the flu, acute bronchitis is considered contagious. These viruses easily spread from person to person, particularly during winter when people are usually close to each other.

However, patients with asthma or chronic bronchitis who develop acute bronchitis as a complication of their primary condition are less likely to be contagious.

What is the difference between acute bronchitis and chronic bronchitis?

Chronic bronchitis is a long-term condition. To be diagnosed with chronic bronchitis, you must have a cough with mucus on most days for at least 3 months.

Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD). Patients with chronic bronchitis can develop exacerbations of acute bronchitis.

Is there any way to prevent bronchitis?

Since acute bronchitis typically occurs as a complication of the common cold or flu, some general prevention measures may help to prevent complications.

What is the difference between bronchitis and bronchiolitis?

Both bronchitis and bronchiolitis affect the airways in the lungs, but bronchitis affects the larger airways (these are called bronchi) and bronchiolitis affects the smaller airways (these are called bronchioles). Bronchitis usually affects older children and adults, while bronchiolitis is more common in younger children.

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